Partial Nephrectomy Use Increasing, but Still Underused
WASHINGTON, D.C.—The rate of partial nephrectomy (PN) performed on patients with renal cell carcinoma (RCC) has increased nearly fourfold from 1998 to 2007 in the United States, but it is still underused, researchers reported at the American Urological Association 2011 annual meeting.
Using data from the Nationwide Inpatient Sample database, Maxine Sun, PhD, of the University of Montreal Health Center, and colleagues analyzed data from 48,321 men with non-metastatic renal cell carcinoma (RCC). PN was performed on 8,551 patients (18%). Results showed that the PN rate increased significantly from 7% in 1998 to 26% in 2007. Patients treated with PN were on average younger than patients who underwent radical nephrectomy (RN) and had a lower baseline Charlson Comorbidity Index. A higher proportion of PN patients than RN patients were treated at academic centers (69% vs. 52%).
After adjusting for potential confounders, octogenarians were half as likely to undergo PN as younger patients. PN was 7% less likely to be performed on women than men, and 11% less likely to be performed on Hispanics than white patients. Compared with teaching hospitals with a low caseload, teaching hospitals with a high caseload were 54% more likely to perform PN. Non-teaching hospitals were 38% less likely to perform PN.